Osteoarthritis

Question 1

what is osteoarthritis?

Answer 1

a degenerative disease od joints that affects all of the weight bearing components of the joint eg bone, articular cartilage and menisci

Question 2

what are some physical features of osteoarthritis?

Answer 2

-thickened capsule
-cyst formation and sclerosis in subchondral bone
-shelving fibrillated cartilage
-osteophytic lipping
-synovial hypertrophy
-altered contour of bone

Question 3

what is the main tissue affected?

Answer 3

articular cartilage

Question 4

what happens to the articular cartilage?

Answer 4

-increased swelling
-change in colour
-cartilage fibrillation
-cartilage erosion down to subchondral bone

Question 5

what are the 3 types of cartilage?

Answer 5

-hyaline (articular)
-elastic (nose/ear)
-fibrocartilage (meniscus/pubic ramus)

Question 6

what do chondrocytes (mesenchymal stem cells) do?

Answer 6

synthesise and maintain extracellular matrix

Question 7

what Is the extracellular matrix?

Answer 7

(mainly collagen II) embedded in gel proteoglycans
hyaluronic acid chains with links containing chondroitin and keratin sulphate
protects chondrocytes from loading forces

Question 8

definition of OA?

Answer 8

progressive disorder of the joints caused by gradual loss of cartilage resulting in the development of bony spurs and cysts at the margins of the joints

Question 9

where does OA often occur?

Answer 9

fingers, hips, knees, thumbs, neck, lower back

Question 10

what are some secondary causes?

Answer 10

-trauma
-hip dysplasia
-infection
-diabetes

Question 11

what are some systematic risk factors?

Answer 11

-age
-genetics
-gender
-nutritional (low vit C and D)

Question 12

what are some joint biomechanical risk factor?

Answer 12

-joint trauma
-obesity
-occupation
-abnormal joint biomechanics
-knee extensor weakness
-sports with joint risk

Question 13

what are some key symptoms?

Answer 13

-pain when doing load bearing activities
-short lived stiffness in the morning generally
difficulty moving affected joints or doing certain activities

Question 14

how can it be identified on an X ray?

Answer 14

-loss of joint space
-osteophytes
-subchondral sclerosis
-subchondral cyst

Question 15

what is the possible treatments?

Answer 15

-meds (general pain killers)
-physio (muscle and tendon strengthening around affected joints)
-walking aids (transfer load to unaffected side)
-joint injections
-weight loss

Question 16

what is cortisone/corticosteroid?

Answer 16

-joint injections which reduce inflammation response around joints
a viscous supplement that can replace synovial fluid in joints and increase viscosity and elasticity of fluid

Question 17

what are some possible surgical treatments?

Answer 17

-athroscopy
-cartilage transplantation
-joint replacement
-bone realignment

Question 18

what is arthroscopy?

Question 19

joint replacement surgery?

Answer 19

-remove worn cartilage and replace with synthetic material
-key objective is pain relief and range of motion
-improves activities of daily living

Question 20

cartilage transplant?

Answer 20

-osteo-articular transplant
-autologous chondrocyte implantation
-cadaver allografts
-osteotomy